血清HB-EGF、HIF-1α水平与狼疮性肾炎患儿预后的相关性

Correlation between of Levels of Serum HB-EGF and HIF-1α and its Prognosis in Children with Lupus Nephritis

【目的】探讨狼疮性肾炎患儿血清肝素结合性表皮生长因子(HB-EGF)、缺氧诱导因子-1α(HIF-1α)水平与患儿预后的相关性。【方法】选取2016年7月至2018年7月榆林市第一医院收治的70例狼疮性肾炎患儿(观察组),对其进行随访观察,随访时间18~36个月。根据随访终止时患儿是否发生复合肾脏终点事件将其分为预后良好组(n=55)和预后不良组(n=15)。选择同期于本院体检的50例健康儿童为对照组,测定入院时不同组别受试者血清HB-EGF、HIF-1α水平,应用受试者工作特征曲线(ROC曲线)及曲线下面积(AUC)评估二者表达水平对狼疮性肾炎患儿预后的预测价值,并对影响患儿预后的相关因素进行Logistic回归分析。【结果】观察组患儿血清HB-EGF、HIF-1α水平均显著高于对照组,差异有统计学意义(P<0.05)。预后不良组患儿血肌酐、血尿素氮及血清HB-EGF、HIF-1α水平均高于预后良好组,差异有统计学意义(P<0.05)。血清HB-EGF、HIF-1α表达水平的曲线下面积(AUC)分别为0.869、0.822,截断值分别为39.692pg/mL、97.448ng/L,敏感度分别为86.70%、66.70%,特异度分别为76.40%、92.70%;二者联合的AUC为0.937,敏感度和特异性为80.00%、96.40%。Logistic分析结果显示:高血清HB-EGF、HIF-1α水平均是影响狼疮性肾炎患儿预后的独立危险因素。【结论】狼疮性肾炎患儿血清HB-EGF、HIF-1α水平明显升高,且其表达水平对患儿预后具有一定的预测价值,二者水平升高是影响狼疮性肾炎患儿预后的危险因素。

【Objective】To investigate the correlation between levels of serum heparin binding epidermal growth factor(HB-EGF)and hypoxia inducible factor-1α(HIF-1α)in children with lupus nephritis and its prognosis.【Methods】A total of 70 children with lupus nephritis(observation group)admitted to the first Yulin hospital from July 2016 to July 2018 were followed up for 18~36 months.The children were divided into good prognosis group(n=55)and poor prognosis group(n=15)according to whether there were composite renal end points at the end of follow-up.A total of 50 healthy children who underwent physical examination in our hospital at the same time were selected as the control group.Levels of the serum HB-EGF and HIF-1αof subjects in different groups were measured at admission.The subjects's operating characteristic curve(ROC curve)and the area under curve(AUC)were used to evaluate the predictive value of their expression levels on the prognosis of children with lupus nephritis,and logistic regression analysis was performed on the related factors affecting the prognosis of children with lupus nephritis.【Results】The levels of serum HB-EGF and HIF-1α in the observation group were significantly higher than those in the control group(P<0.05).The levels of serum creatinine,blood urea nitrogen,serum HB-EGF and HIF-1α in the poor prognosis group were significantly higher than those in the group with good prognosis(P<0.05).The expression level of the area under the curve(AUC)of serum HB-EGF and HIF-1α were 0.869 and 0.822 respectively,the cut-off values were 39.692 pg/mL and 97.448 ng/L respectively,the sensitivity were 86.70% and 66.70% respectively,and the specificity were 76.40% and 92.70%respectively;The combined AUC was 0.937,the sensitivity and specificity were 80.00% and 96.40%.Logistic analysis showed that high levels of serum HB-EGF and HIF-1α were independent risk factors influencing the prognosis of children with lupus nephritis.【Conclusion】The levels of serum HB-EGF and HIF-1α in children with lupus nephritis has increased significantly,and its expression level has a certain predictive value for the prognosis of children with lupus nephritis.